Social and cultural changes and media scrutiny have fed to increased public
awareness of the patient's role in medical care. Decisions are no longer d
irected by physicians alone and are affected by several nonmedical factors,
in the current environment, physicians must respond actively to how patien
ts perceive their care and how they make decisions about themselves to aid
in risk management Patients and families with high-risk profiles for litiga
tion have been identified, and it is important to be aware of these subsets
. Gender differences and patients' hidden histories can affect their decisi
on making and relationships with physicians, Mistaken concepts about medica
l care, patients' beliefs in alternative medical treatments, and patients'
magical beliefs must also be considered in assessing communication with pat
ients and their families, and are useful in constructing a risk-management
strategy. factors contributing to malpractice suits and a proposed risk-red
uction protocol that physicians can fallow to decrease legal risk are also
discussed, (C) 1999 by Excerpta Medica, Inc.